: This study aimed to analyse the potential influence of abnormalities detected through carotid-vertebral ultrasonography and brain MRI on pure-tone averages (PTAs) and the frequency and intensity of Tinnitus. : 423 participants with subjective Tinnitus were enrolled in this investigation. All patients underwent carotid- vertebral ultrasonography, brain MRI, and pure-tone audiometry, including Tinnitus matching. : The median values for Tinnitus onset indicated chronic Tinnitus in most cases. Regarding Tinnitus location, left-sided symptoms (32%) and bilateral symptoms (44%) were the most prevalent. In analysing the effects of abnormalities detected by carotid-vertebral ultrasonography on PTAs, a statistically significant difference was found between the groups ( = 0.0037). Specifically, individuals with intimal hyperplasia had significantly higher PTAs ( = 0.02), as did those with carotid artery plaques ( = 0.005). However, no significant differences in PTAs were noted in relation to carotid artery stenosis ( = 0.07). Similar trends emerged regarding Tinnitus intensity ( = 0.013), with significantly higher values observed in the presence of any carotid-vertebral ultrasonography abnormalities. In contrast, Tinnitus frequencies were not significantly affected ( = 0.401). Regarding brain MRI findings, Fazekas scores of 2 ( = 0.02) and 3 ( = 0.0052) significantly influenced PTAs. For Tinnitus intensity, Fazekas scores of 2 ( = 0.0027) and 3 ( = 0.0005), and the presence of acoustic neuromas = 0.019), significantly impacted the intensity values. However, Tinnitus frequencies were not significantly ( = 0.36) influenced by brain MRI abnormalities. : The findings of this study show that carotid-vertebral ultrasonography and brain MRI abnormalities significantly influence PTAs and Tinnitus intensities.
